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<br /> � Natice of �#ate Tax Li�n �
<br /> nabraska
<br /> � �artment
<br /> af revenue •Read fnsl�+;CtFans o�reverse side
<br /> __ Lfen Sariai Number Lten TyRe Oate Soefal Stcar'ty.T�€�iRper
<br /> �Otl9ina! .
<br /> 0/03/616 [i Rertewal �-15�9� 5U,7..�6�r-�,'u , A „� � '
<br /> Nebroska I.D.No. Counfy L:enFited WifR 5;.�;r,�(ws,'r,�.rsf'.t3�;ty .Qf■��O f 2��.
<br /> '� Ncr.;C,a' N Y ��+�� . .
<br /> 5O�7j�S �, .. ,':-� RegtslE:�oi Oecsas . • ,
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<br /> ._� • �•ii�,��• '.'a`.�Ca"_^S»C��etk • .`'�`.
<br /> BUSIN�fxY�:R���I':tIC/LT10N ADDHF.SS T,RXPAYER NA'.,ZE AND MAILfNG ADDRESS
<br /> Business Nam� hame ,.
<br /> � , Ronald L. Wagner
<br /> Street AGdr�55 Sfreot or Othet Malling ACtlrass
<br /> 121Q tlest Division �
<br /> City State Zip Codo City � State zip CoDe
<br /> � Grand Island P!E 68801
<br /> This N�qce of.State Tax Llei�is issuc�Gy the Nebraska�epartment of Revenue far unpaid taxcs pursuant to the �
<br /> reveaue law�s of the st�te of Nebragka. Notice is hereby given that trxes includeng penalties arrd intetest,which are
<br /> shown betow,are due frnm the taxpayer speci�ed abo��e and remain unpaid after demand.These taxes constitute .
<br /> = a lien in the�co�nty for r�+l and peasonal propetiy 6elanging to rthe taxpayer or hereafter acquired.
<br /> T� Dace of Batan�a ot
<br /> Cst�pory Tax Pt►tad Assessmant amount ot Tas Pertalty Interest Additiom
<br /> Numher As:essme�t Dus �
<br /> 7-0 -86 thru •
<br /> �
<br /> 21 12-3��«E6 2-15-90 0.00 0.00 710.96 31!(�..g6
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<br /> � 3�
<br /> TOTAL S 110 96
<br /> • � �,.,:� 1 t�ericy 6ortHy that the Nebraska Departmont uf Revenuo has �,•,QUCa viith tho rovenue tavis ot tho Statc ot Nebraska in tho Aeter-
<br /> r �+..• minatlo�,-:ot tho amount shov�n tn bo aue,antl tne taxpayer has`a eG to pa� tho amount tlue altor tlemand. If this No[ICO of Stato Tax
<br /> t � �•��.ten Is an extnnsl n ot an vNectivo��en it serves to cc„c.nuo tne pnonty ot tne stato's Intorest�n tho alfectea propartv of tno taxpayoa +
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<br /> � �a�g r •• `�-�� F�-�-�`� "axpa.vers Service Speci al i st --s=���� �� � �
<br /> ,�here ��"� t� la=9naturo ":t�o Uate �' '�
<br /> ,. �?��lenue A�ent Supervisor �.
<br /> � Auttiorls�ct5ignatut� 'ctte ;13`� -- - - ,,�
<br /> �,��� +�� FOR COUNTV OFC:CIA!'S USE �^"�',
<br /> i THE 11S'X'1�i,.^H8D DiOTICE(S} 'OF TAX LIEti (OR `�EEFlI2�]�TI�tJ) IS (ARE) TO HE FILED ONf►�'iI2',!�
<br /> TM1t ���lt C1E' DEEDS. .
<br /> T[3B DOCUMENT(S) IS (ARE) NOT TO B8 FORWIIRDED TO THE COUI3TY CLERK.
<br /> DISTREBUTION OF COPIES: T
<br /> • � WHITE= TO HE VALIDATED BY THE REGISTER OF DEEDS AND RETURNED TO TfiE
<br /> - � bEPARTi1ENT OF REVEN(TE.
<br />� GOLDENRaD: TO BE 10EPT BY Tf3E REGISTEI2 OE' DEEDS.
<br /> BILLZN(3 IS TO BB ONCE PER MONTH l►ND THERE WILL $E NO PRE-PAYMENT OF �'EES.
<br /> Tt�lltili XOU FOR YOUR CO.OP�FtATION.
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<br /> 5..�^:�'.:-3::t.;,�4•Y4 Rcv.7•83 i
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